Provider Demographics
NPI:1043503469
Name:CORPORATESPEEK INC
Entity Type:Organization
Organization Name:CORPORATESPEEK INC
Other - Org Name:PHOENIXN THERAPY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AKILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRY MCCAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA,CCC-SLP
Authorized Official - Phone:773-233-7855
Mailing Address - Street 1:2145 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-1018
Mailing Address - Country:US
Mailing Address - Phone:773-233-7855
Mailing Address - Fax:
Practice Address - Street 1:2145 W 95TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-1018
Practice Address - Country:US
Practice Address - Phone:773-233-7855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency